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The advanced practice nursing role in neonatal intensive care enjoys an almost 40-year history. The 1970s and the 1980s were fraught with growing pains, including what to call these providers, and role clarity that was defined in most settings by community need. With the birth of NANN, 25 years ago, the neonatal nurse practitioner (NNP) role began to receive support and advocacy that led to the development of educational standards and definition of the role. This article reviews the role's history and identifies current and future issues that will require attention by the national NNP leadership.